It’s 3:54 A.M. and you’re jolted awake, wheezing and coughing until a few puffs on your inhaler ease the tightness in your chest. Sound familiar? If you have nocturnal (or nighttime) asthma, you’re not alone: A University of Colorado study of nearly 8,000 people with asthma found that 39% were awakened by asthma symptoms at least once each night. About two-thirds reported having nighttime asthma episodes three times a week, and three-quarters had to reach for their inhalers about one night a week. In addition, the American Lung Association reports that asthma symptoms are often worse at night.

Why do asthma symptoms worsen at night?

As early as the seventeenth century, doctors noticed that asthma symptoms seem to intensify at night. But it wasn’t until recently that medical researchers discovered circadian rhythms, the answer to this 300-year-old riddle. Circadian rhythms are internal cycles that affect the body’s hormone production. These normal variations in hormone levels help regulate all of your vital functions, including breathing. Human lung function usually reaches its peak at 4 P.M. and its lowest point at 4 A.M. For people who don’t have asthma, the difference is only 5% to 8%; for people with asthma, lung function can decrease by as much as 50%. As your lung function decreases, you become more sensitive to your triggers, and you’re more likely to have an asthma episode.

How can I reduce nocturnal asthma?

The best way to reduce nocturnal asthma is to avoid your asthma triggers — especially in the bedroom. Pay special attention to eliminating common bedroom culprits such as dust mites and pet dander. Here are some other factors that may contribute to nocturnal asthma:

• Exposure to allergens late in the evening may spark an asthma episode during the night. Make a special effort to avoid asthma triggers just before bedtime.
• About 70% of people with asthma also have chronic bronchitis. Talk to your doctor about how to keep sinuses clear to prevent postnasal drip from blocking your airways and worsening nighttime asthma symptoms.
• Sleep apnea (when breathing stops temporarily during sleep) is a condition that affects the upper airway, but symptoms of this condition may trigger an asthma episode in the lower airway. The major warning signs of sleep apnea are loud snoring and persistent fatigue. If you suspect you have sleep apnea, seek diagnosis and treatment from your health care provider.

Is there medication for nocturnal asthma?

In cases where avoiding asthma triggers is difficult, or simply not enough to head off a nighttime episode, your doctor may prescribe a beta-agonist. This is a type of medication that helps relax the muscles in the airway and reduces constriction. Long-acting beta-agonists are more effective at controlling nocturnal asthma than the shorter-acting varieties. Rather than working fast to relieve existing asthma symptoms, long-acting beta-agonists help prevent symptoms. Other drug treatments can be time-released into the bloodstream so that medication levels are highest during the night. Your doctor will fill you in on the details.

As a general rule, nocturnal asthma can be a sign of poorly controlled asthma. If you notice an increase in nighttime episodes, tell your doctor. Minor adjustments in your asthma management plan can help reduce nocturnal asthma symptoms — and will likely improve your daytime asthma as well. With the help of proper medication and overall asthma management, you can look forward to sleeping through the night, asthma free.

This entry was posted on Thursday, October 18th, 2007 at 9:31 am and is filed under Sleeping & Snoring. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.